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Health & Wellness

Podcast 147: Understanding Metabolic Health with Dr. Casey Means

November 2, 2021

The effect of sleep, exercise, diet & stress on glucose levels.

By Will Ahmed

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This week’s episode covers a topic that is on the rise: Metabolic health.

Only 1 in 8 of Americans are considered metabolically healthy – a measure of your blood sugar, cholesterol, blood pressure, waist circumference and triglycerides – which is alarming considering metabolic dysfunction is the root cause of many chronic illnesses.

Our VP of Performance Kristen Holmes sits down with Dr. Casey Means, a Stanford-trained physician and Chief Medical Officer and Co-Founder of the metabolic health company Levels, for an in-depth discussion on metabolic health. Dr. Means is on a mission to reverse the epidemic of preventable chronic disease, and that all starts with the right choices when it comes to your diet, sleep, exercise, and stress levels.

Stay healthy and stay in the green!


Metabolic Health with Dr. Casey Means Podcast Quotes & Highlights

2:37 – Combating Chronic Disease. Casey explains how she transitioned from her career as a head and neck surgeon to her role at Levels. “All of the interventions I was doing in my conventional medical practice were reactive in nature. It was not proactive. It was waiting until symptoms and diseases emerged.”

4:14 – Inflammation and Health. “I became really interested in understanding the root causes of inflammation and how to mitigate those really in hopes of keeping people out of the operating room. And in that journey, we realized that one of the key fundamental triggers of inflammation in the body is dysregulated blood sugar and metabolic dysfunction.”

6:13 – Chronic Illness and Lifestyle. “The vast majority of the issues we’re dealing with in the United States are chronic illnesses that are related to diet and lifestyle. But we are not treating them in a way that actually approaches diet and lifestyle, and that’s why we’re failing. That’s why Americans are getting sicker. Depression is going up. Weight is going up. Chronic disease is going up and healthcare costs are going up because we’re not actually approaching the issues by addressing the mechanisms that actually cause them.”

7:56 – Glucose Spikes and Health. Casey explains what happens when your body experiences a spike in glucose and how that affects your insulin levels and metabolic health. “You want the least spiky [glucose] graph possible. You do not want the peaks and valleys, you want the gentle rolling hills. … It’s the really big, repeated spikes that can cause severe dysfunction in the body relatively rapidly.”

12:55 – Warning Signs. Casey cites a study from the Lancet indicating that people diagnosed with Type 2 Diabetes had signs of insulin resistance up to 13 years before diagnosis. She also notes that infertility and erectile dysfunction can often be a sign of metabolic issues. Gout, fibromyalgia, depression, and anxiety are also indicators of metabolic dysfunction, according to Casey.

15:29 – Glucose, Insulin & Weight Loss. Casey explains the relationship between metabolic health and weight. “If you’re dealing with stubborn weight loss issues, it is very likely that insulin is high in your body.”

17:09 – The 4 Pillars of Metabolic Health. Casey says food, sleep, exercise, and stress management are the biggest factors in determining your metabolic health.

17:33 – Sleep and Glucose Levels. “The less sleep you get, the higher your glucose levels are going to be and the more insulin resistant you’re going to be,” Casey notes, adding that even having 3 or 4 days of sleep deprivation can have a serious impact on your body.

20:46 – Impact of Interrupted Sleep. Casey references a study from Japan that showed that people who have interrupted sleep have a higher risk of developing diabetes.

25:21 – Exercise and Glucose Spikes. “You can see a big spike after a high intensity interval training workout. Typically, when you go above about 80% of your VO2 max or, as a proxy, about 80 percent your max heart rate, you are going to start to see glucose rise in the bloodstream.” Casey goes on to explain how this helps you burn fat.

28:53 – The Study. WHOOP and Levels teamed up for a study evaluating how blood glucose levels interact with sleep, exercise, and recovery. The study found that higher levels of sleep and lower measures of stress (resting heart rate and heart rate variability) were associated with better metabolic health. The research also found that the previous day’s glucose management associates with sleep consistency the following day.

39:43 – Sleep Consistency. “I think it’s actually the core behavioral anchor,” Kristen says of sleep consistency. “To me, it’s becoming more and more obvious that if we’re to focus on one behavior, it’s to stabilize our sleep-wake time.”

41:49 – Food Pairing. Casey talks about the importance of food pairing and what people should understand about avoiding “naked” carbohydrates, food that is “carb-forward” without other macronutrients. She suggests pairing carbs with fiber, protein, and fat.

46:33 – Walking After Meals. Casey details how walking after a meal can lower your glucose spike. “Walking is incredible for metabolic health in general. There have been lots of studies showing just walking a minute and a half every 30 minutes can totally change your glucose and insulin levels throughout the course of the day.”

50:39 – Chronic Disease: A Product of Our Lifestyle. “As an American adult, unfortunately, if we’re not doing something different than the normal of American life, we are going to get a chronic illness. That’s essentially a given,” Casey says. “If you’re going on the treadmill of the way culture is pushing you, meaning standard American diet, sitting eight hours a day at work, having your screens in bed, having your phone alarms going off at night, you’re going to get sick.”

Connect with Casey on Instagram, Twitter, and at


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Will Ahmed

Will Ahmed is the Founder and CEO of WHOOP, which has developed next generation wearable technology for optimizing human performance and health. WHOOP members include professional athletes, Fortune 500 CEOs, fitness enthusiasts, military personnel, frontline workers and a broad range of people looking to improve their performance. WHOOP has raised more than $400 million from top investors and is valued at $3.6 billion, making it the most valuable standalone wearables company in the world. Ahmed has recruited an active advisory board that consists of some of the world’s most notable cardiologists, technologists, marketers, and designers. Ahmed was recently named to the 2021 Sports Business Journal 40 under 40 list as well as 2020 Fortune 40 Under 40 Healthcare list and previously named to Forbes 30 Under 30 and Boston Business Journal’s 40 Under 40. Ahmed founded WHOOP as a student at Harvard, where he captained the Men’s Varsity Squash Team and graduated with an A.B. in government.